{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T05:20:31Z","timestamp":1791523231501,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01AG038791"],"award-info":[{"award-number":["R01AG038791"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01AG062562"],"award-info":[{"award-number":["R01AG062562"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01NS105741"],"award-info":[{"award-number":["R01NS105741"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R35NS111644"],"award-info":[{"award-number":["R35NS111644"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020463","name":"Valhalla Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020463","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["RO1AI170863"],"award-info":[{"award-number":["RO1AI170863"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014842","name":"Race to Erase MS","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014842","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007366","name":"Fondazione Italiana Sclerosi Multipla","doi-asserted-by":"publisher","award":["2019\/BC\/002"],"award-info":[{"award-number":["2019\/BC\/002"]}],"id":[{"id":"10.13039\/100007366","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000890","name":"National Multiple Sclerosis Society","doi-asserted-by":"publisher","award":["RG\u20101707\u201028564"],"award-info":[{"award-number":["RG\u20101707\u201028564"]}],"id":[{"id":"10.13039\/100000890","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Spinal cord (SC) atrophy correlates with and predicts the underlying progressive biology in active and non\u2010active multiple sclerosis (MS), thereby providing a biomarker for clinical trials and patient management. Initiation of disease\u2010modifying therapy (DMT) may be followed by early pronounced central nervous system (CNS) volume loss due to resolution of inflammation (pseudoatrophy) and confounding the interpretation of atrophy. High\u2010dose glucocorticoids (HDGs) reduce inflammation and might therefore modify pseudoatrophy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One hundred twenty\u2010three newly diagnosed and DMT\u2010na\u00efve MS participants (relapsing\u2013remitting, 70% female participants, median age\u2009=\u200936\u2009years, Expanded Disability Status Scale [EDSS] 2.0) were followed for up to 3\u2009years. Forty\u2010two participants received HDG before baseline magnetic resonance imaging (MRI; DMT\u2010HDG; median\u2009=\u200952\u2009days, interquartile range [IQR]\u2009=\u200937\u201371), whereas 60 did not (DMT\/no\u2010HDG). Twenty\u2010one participants remained untreated (no\u2010DMT), and 102 started DMT after baseline MRI. SC total cervical cord cross\u2010sectional area (TCA), gray matter area (GMA), and white matter area (WMA) and regional brain volumes were analyzed using mixed effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The DMT\u2010HDG, DMT\/no\u2010HDG, and no\u2010DMT groups had similar demographic, clinical, and radiological features. Pronounced SC pseudoatrophy was observed based on more year 1 versus year 2 volume loss for DMT\/no\u2010HDG (\u22122.06% vs. 0.83%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.02) but not DMT\u2010HDG (\u22120.51% vs. 0.66%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.8) and more year 1 volume loss for DMT\/no\u2010HDG compared to DMT\u2010HDG (\u22122.06% vs. 0.51%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>HDG preceding baseline MRI suppresses CNS white matter (WM) pseudoatrophy after DMT initiation, most conspicuously for the SC. Suppression of pseudoatrophy with HDG may improve the fidelity of clinical trials and enhance the feasibility for short\u2010term trials with SC and brain MRI outcomes in active MS by pretreatment with HDG. ANN NEUROL 2025;98:837\u2013850<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.27298","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T06:06:40Z","timestamp":1750745200000},"page":"837-850","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["High\u2010Dose Pulse Glucocorticoid Treatment Prevents White Matter Spinal Cord Pseudoatrophy in Newly Diagnosed Multiple Sclerosis"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8789-3099","authenticated-orcid":false,"given":"Simone","family":"Sacco","sequence":"first","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico","family":"Papinutto","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8875-0567","authenticated-orcid":false,"given":"Vinicius A.","family":"Schoeps","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuiting","family":"Cheng","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William A.","family":"Stern","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haojun","family":"Zhao","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3862-5738","authenticated-orcid":false,"given":"Antje","family":"Bischof","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital of Muenster  Muenster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Caverzasi","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioral Sciences University of Pavia  Pavia Italy"},{"name":"Advanced Imaging and Artificial Intelligence, Department of Neuroradiology IRCCS Mondino Foundation  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manula","family":"Dombagahawatta","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Juwono","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Akula","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1413-0442","authenticated-orcid":false,"given":"Christian","family":"Cordano","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"},{"name":"Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) University of Genoa  Genoa Italy"},{"name":"IRCCS Ospedale Policlinico San Martino  Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5974-8916","authenticated-orcid":false,"given":"Alexandra","family":"Beaudry\u2010Richard","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology University of Ottawa  Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Refujia","family":"Gomez","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meagan","family":"Harms","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Santaniello","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riley M.","family":"Bove","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Gelfand","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas S.","family":"Goodin","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari J.","family":"Green","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge R.","family":"Oksenberg","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5188-0157","authenticated-orcid":false,"given":"Emmanuelle","family":"Waubant","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8705-5084","authenticated-orcid":false,"given":"Michael R.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2720-9915","authenticated-orcid":false,"given":"Scott S.","family":"Zamvil","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7689-2533","authenticated-orcid":false,"given":"Bruce A. C.","family":"Cree","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4932-4001","authenticated-orcid":false,"given":"Stephen L.","family":"Hauser","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8232-7562","authenticated-orcid":false,"given":"Roland G.","family":"Henry","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, Department of Neurology University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30451-4"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-014-0140-z"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458515616701"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24241"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26281"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514564494"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000316810.01120.05"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000200977"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458513488231"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-70255-z"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2004.tb00279.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000149516.30155.B8"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514556300"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15620"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30460-5"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2017.00433"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2005.03.006"},{"key":"e_1_2_9_19_1","first-page":"977","article-title":"Corticosteroid hormonal influence on cranial computerized tomography: observations in the rhesus monkey","volume":"10","author":"Raskin RJ","year":"1983","journal-title":"J Rheumatol"},{"key":"e_1_2_9_20_1","article-title":"Steroids for acute spinal cord injury","volume":"1","author":"Bracken MB","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.3747\/co.19.1128"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/307064"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2021.120004"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458515599072"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.51302"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-015-0488-9"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2016.09.011"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2023.103354"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2012.02.084"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12666"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/13524585221143726"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.59.5.688"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1191\/1352458502ms838oa"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458512473190"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12337"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.4161\/pri.22580"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-062446"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-006-0264-2"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.63.8.1175"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25145"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2007.134825"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0206939"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.51700"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2023.105123"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-017-0415-2"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2012.1051"}],"container-title":["Annals of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ana.27298","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T11:15:25Z","timestamp":1761131725000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ana.27298"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,24]]},"references-count":45,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/ana.27298"],"URL":"https:\/\/doi.org\/10.1002\/ana.27298","archive":["Portico"],"relation":{},"ISSN":["0364-5134","1531-8249"],"issn-type":[{"value":"0364-5134","type":"print"},{"value":"1531-8249","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,24]]},"assertion":[{"value":"2024-12-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}